JOURNEY FORWARD

A RESOURCE GUIDE FOR IOWA’S FARMERS WITH DISABILITIES

CREATED FOR FARMERS & PEOPLE IN RURAL SETTINGS WHO HAVE RECENTLY ACQUIRED A DISABILITY

DISABILITY RIGHTS IOWA Is a non-profit law center using the law to protect the rights of Iowans with physical, intellectual, developmental or psychological impairments

DRI’S VISION: All Iowans with disabilities and/or mental illness have the opportunity to live, work and learn in the most integrated settings, with the supports and services they need, free of abuse, neglect, stigma and discrimination.

MISSION: To advance and protect the rights of Iowans with disabilities and/or mental illness to dignity, equality, integration, self-determination and appropriate services and supports.

FUNDING: This document is funded in part through grants from the Substance Abuse Mental Health Services Administration and the Administration for Community Living in U.S. Department of Health and Human Services. This document is also funded in part through a Social Security grant agreement. Although Social Security reviewed this document for accuracy, it does not constitute an official Social Security communication. DRI published this guide at U.S. taxpayer expense.

CONTACT INFORMATION: Iowans can request services from Disability Rights Iowa by calling 1-800-0779-2502 x 12 or 515-278-2502 x 12 or by filling out an online intake form at https://disabilityrightsiowa.org/contact-disability-rights-iowa/let-us-help/. DRI’s intake specialist will ask you for information about yourself and your issue. DRI staff will then determine whether they can represent you based on federal grant eligibility criteria, DRI’s Board-approved areas of focus and other matters. If DRI cannot represent you, DRI will try to provide you with information and referrals. DRI’s services are provided at no charge to you.

Disclaimer: This information is intended to provide guidance and general information. No portion of this guidebook should be used as a substitute for legal advice. When specific situations arise, individuals should consult legal counsel or contact Disability Rights Iowa.

INTRODUCTION:FARMING IS A PROFESSION OF HOPE 1

The purpose of this guide is to give hope to Iowa farmers and their families about how to move forward after an illness, injury or disability. Life is not over, only changed. Throughout their lives, farmers have been resilient when confronting changing weather, markets, and government policies. Likewise, farmers and their families have the skills, intelligence and resources to weather changes in their physical and mental abilities. This guide explains how farmers with disabilities can continue farming after they become disabled.

We are grateful to the Oklahoma authors of “Agriculture for Life: Health Promotion and Successful Farming and Ranching for Ag Families – A Planning Guide and Workbook”2 for generously allowing us to adapt their Ag4Life Guide for use in Iowa. We hope this Iowa guide will help Iowa farmers with disabilities and their families have what they need to move forward and continue Iowa’s great tradition of providing food to the world.

Jane Hudson, Executive Director, Disability Rights Iowa

TABLE OF CONTENTSAcquiring a Disability: Page 3

Rick Meister’s Story: Page 5

Iowa’s Center for Agricultural Safety and Health | I-CASH: Page 9

Kaleb Groenenboom’s Story: Page 11

Easterseals Iowa Rural Solutions: Page 13

Iowa Vocational Rehabilitation Services | IVRS: Page 15

Renae Beebout’s Story: Page 20

Working with AgrAbility: Page 21

Modifying Your Home and Farm: Page 23

Stress and Mental Health: Page 25

Moving Forward: Page 27

Resources: Page 29

Acknowledgements: Page 30

1 Quote from Brian Brett, poet, memoir writer, and fiction writer. 2 “Agriculture for Life: Health Promotion and Successful Farming and Ranching for Ag Families” was created by Oklahoma State University, Oklahoma Cooperative Extension, Oklahoma Assistive Technology Foundation (OkAT), Oklahoma ABLE Tech; and Langston University, School of Physical therapy. Agriculture for Life by Oklahoma State University-Cooperative Extension is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. The Guide can be accessed at https://www.ok.gov/ag4life/Publications/Guidance_Document/index.html.

PAGE 2

ACQUIRING A DISABILITYHow do I know if I have a disability?

Many of us will acquire a disability at some point in our lifetime. According to the most recent US Census, one out of every five Americans has a disability. According to a 2017 survey by the State Data Center of Iowa and the Office of Persons with Disabilities, 11.9% of Iowans have a disability.

Disability is an umbrella term. It covers impairments, activity limitations, and participation restrictions. These can affect working, living independently, and mobility.

Disabilities can be caused by physical changes of the body, the environment, and even society.

We typically think of only the first two conditions. However, even with accommodations, disabilities can affect the way that people interact in social spaces.

SITUATIONS TO THINK ABOUT

SITUATION 1: A crop farmer may lose both legs and not be able to move about his home or field as he did before. This is a common example of a disability that people think of. But what if he is able to receive a pair of prosthetic legs or other assistive devices that allow him to walk again? The farmer still has a physical impairment, but much of the effect of the disability has been removed.

SITUATION 2: A person with a spinal cord injury could use a wheelchair to become more mobile and go places that they need to go. The chair also reduces the limitations of having a spinal cord injury and provides the user with a sense of freedom. However, there can still be limitations for people who use wheelchairs. For example, they may discover that they cannot access a stadium seat and sit with their friends because of a lack of ramps and accessible walkways. In this situation, part of the physical environment is causing a disability. This is the reason the Americans with Disabilities Act is used to remove environmental barriers that contribute to an individual’s lack of access.

10 WAYS TO STAY RESILIENT

1. Make connections

Good relationships with others areimportant. Accept help and support from those who care about you. Be active inyour community.

2. Avoid defeatist thinking

You may not be able to change the past,but you can change your responses.

3. Accept change as part of life

Goals you had prior to experiencing adisability or chronic illness may no longerbe attainable in the same form, so focuson adapting your goals to your future.

4. Move towards your goals

Develop realistic goals and take smallsteps. Don’t focus on what seemsunachievable. Instead think: What’s onething I can accomplish today that helpsme move in the direction I want to go?

5. Take decisive action

Act during adverse situations as much asyou can rather than avoiding problemsand hoping they go away.

6. Look for opportunitiesfor self-discovery

Learn new things about yourself andothers. Let the experience teach you andallow you to grow.

7. Nurture a positive view of yourself

Develop confidence in your ability tosolve problems and trust your instincts.

8. Keep things in perspective

Avoid blowing events out of proportion.Practice having a long-term perspectiveon life.

9. Maintain a hopeful outlook

Visualize what you want to achieve andhow you can do it instead of worryingabout your fears and possible barriers.

10. Take care of yourself

Engage in activities that you enjoy andfind relaxing. Take steps to manage yourhealth conditions to the best of yourability.

Dealing with disabilities takes perseverance, good decision-making skills, and plenty of support. You may also need to consider how you deal with stress, what your coping mechanisms are, and where you are in terms of acceptance.

Though most of us are good at adapting, bigger changes to our lives can rock the boat. When confronted with a life-altering change, we grieve the potential loss of status quo. Often, people go through all five stages of the process of grief when facing drastic lifestyle changes. It is important to remain true to your life goals and continue working to accomplish them.

PAGE 4

I had to hold myself out of the combine head . . . otherwise I would have gone all the way through the machine.

Rick’s Story

THE FIELD OF RICK MEISTER’S FARM was damp one fall morning, making it hard for his farm equipment to function. He had already stopped the chains of his combine twice to clear the stalks that were clogging the machine’s tines and rollers. As the combine jammed a third time, out of frustration Rick threw caution to the wind and left the chains and rollers running while he cleared the blockage again. As he got close to the head of his combine, the chains snagged on his blue jeans and dragged him in.

“I had to hold myself out of the combine head until it cut both of my ankles off. Otherwise I would have gone all the way through the machine,” Rick says as he thinks back. “And then, well, I fell on the ground.”

Like any other day, Rick’s three sons were also tending to the family farm. Jarod wondered what was taking his dad so long. He found his father on the ground after going to look for him.

Jarod immediately called his other brothers over to try to save Rick’s life. Rick drank water to stay hydrated while his sons used their belts as makeshift tourniquets to stem the bleeding.

Once the Lake View Fire Department arrived, Rick recalled a feeling akin to being pulled out of concrete as the rescue team lifted him into the ambulance. The first responders told Rick he was going to make it.

“We’ll see,” Rick had replied.

-----

Back at home, Rick’s wife, Jackie, was bagging leaves in the garden. A neighbor with a family member in the fire department gave Jackie the news that her husband had been in a bad accident and that Jackie needed to get to the hospital.

The family assembled in the hospital. When they got there, a priest was giving Rick his last rites.

Jackie made her way to Rick’s bedside and he recounted the accident. They prayed, and then Jackie saw Rick to the helicopter that would take him to the Omaha Nebraska Medical Center.

-----

Rick woke next around 2 a.m. in a hospital room with his wife, children, and a young doctor from Minnesota. He’d had surgery to remove both of his legs above the knee. His hospital stay lasted eight days, followed by another 13 days at Madonna in Lincoln, Nebraska, for physical therapy.

PAGE 6

GOING HOME WAS GREAT, but returning to the farm was an emotional moment for everyone.

With a lot of hard work and a touch of tough love from Jackie, Rick is back to living his life. While he can’t do all of the things he used to, Rick is able to move through life independently by using a wheelchair, hand controls on his truck, and a lift that can help him maneuver his body up to 12 feet in the air.

“The lift has almost given me my life back because I can come and go when I want to. In the summertime, my job is to mow the grass, and I can get in and out of the mower when I want to. I don’t have to have somebody around,” Rick explains. “I do all the field work. I don’t plant the corn, but I do all the preparation before so I can get in the tractor and go. If I have to go to the bathroom, I go to the bathroom. I come and go. I do what I want. The kids everyday have a long list for me to go run and do things, and I can do that.”

Reflecting back on his first days in the hospital, Rick remembers looking at a chair in the corner thinking, “Do I want to sit in this corner, or do I want to go out there?”

“It was not easy, but I have grandkids and I want to be with them, and I don’t want to sit in that corner. Someday I might want to, but not now. Plus, I’ve got too much started out at the farm that I want to see through to completion.”

It was not easy, but I have grandkids and I want to be with them. Plus, I’ve got too much started out at the farm that I want to see through to completion.

PAGE 8

I-CASH - IOWA’S CENTERFOR AGRICULTURALSAFETY AND HEALTHAgriculture remains one of the most dangerous jobs nationwide, especially in Iowa. Most years, rates of occupational fatalities are higher in agriculture than in any other industry in the state. Farming is complex work with slim profit margins, tight deadlines, and volatile markets. In addition, farmers and agricultural workers come into contact with large equipment, livestock, chemical hazards, confined spaces, and occupational stress every day.

These hazards are reflected in the incidents that result in injuries and fatalities every year. In 2016, the rate of occupational fatalities related to agriculture was 16.7 per 100,000 full-time workers. That rate is higher than any other industry in Iowa and more than three times the overall rate of 4.8. Fatalities and injuries related to tractor and equipment operation have been consistently high. In recent years, grain-related fatalities have become an increasing problem, as have fatalities related to manure gases. Recent years have also seen increases in nonfatal injuries related to falls, machinery, and natural environment exposures like heat.

Despite all of these hazards, farmers are largely on their own for safety management. The Occupational Safety and Health Administration (OSHA) does not provide regular oversight to businesses that employ 10 or fewer workers each year. While the farm community may welcome lack of regulation, one downside is that OSHA does not serve as a resource for farmers the same way that it does for other industries, where inspectors can provide guidance and best safety practices.

All of I-CASH’s resources are available at www.i-cash.org. I-CASH strives to be responsive to the needs of Iowa’s rural communities and invites you to contact them if they can be of help at cph-icash@uiowa.edu.

Iowa’s Center for Agricultural Safety and Health (I-CASH) is a key safety resource for Iowa’s farmers and rural residents. Founded in 1990 by an act of the state Legislature, the center combines the expertise of the University of Iowa’s College of Public Health, Iowa State University’s College of Agriculture and Life Sciences, the Iowa Department of Public Health, and the Iowa Department of Agriculture and Land Stewardship. These four institutions have extensive expertise in combining public health prevention and education with agricultural practices to promote safer and healthier rural communities.

I-CASH develops outreach and educationalmaterials for farmers as well as for others inthe agricultural industry who rely on a safeand healthy farm workforce. These includeequipment manufacturers and dealers,extension personnel, agricultural lenders,and input dealers. I-CASH aims to provideagricultural safety and health throughoutrural communities, recognizing that theburden of agricultural safety and health canbe shared by many stakeholders.

The tools I-CASH develops address some of the most significant hazards in agriculture, including chemical handling, ATV use, mental health, and rural roadway safety. I-CASH regularly partners with ISU Extension and Outreach and Farm Service Agency offices to distribute materials. In a recent survey of those offices, 61 percent indicated that they had learned more about hazards in agriculture as a result of I-CASH materials, and 83 percent agreed that health and safety issues in agriculture do

not get enough attention. I-CASH is glad to be raising awareness of these issues among a wide range of agricultural stakeholders in rural Iowa.

I-CASH empowers rural youth to take onsafety programs through its agriculturalyouth injury prevention grant, which hasbeen awarded since 1998. These smallgrants are awarded to Iowa youth groupsthat propose safety projects that the youthhave a significant role in developing andexecuting. The youth grants encourageyoung people to work for a greater goodin their community and may inspire a newgeneration of advocates for safe agriculturalpractices.

I-CASH also partners with agriculturalmedia to produce the Safety Watch columneach month in Iowa Farmer Today. Thiscolumn includes incident profiles, policyinformation, technical assistance, andhealth and wellness information. Thesearticles are available online and are effectivein agricultural classrooms as well as in farmhouseholds.

Each year, I-CASH convenes health and safety researchers, public health practitioners, farmers, and others for the Midwest Rural Agricultural Safety and Health conference. Usually held in a rural Iowa community, the conference is an opportunity for researchers and practitioners to hear directly from rural people about their health and safety concerns. The conference also provides an important forum for research and discussion related to current emerging issues in farm safety and health.

PAGE 10

Kaleb’s Story

KALEB GROENENBOOM HAD NO INTENTION TO STOP FARMING after an accident in 2004 took his right leg and injured his left calf. After a 10-day hospital stay and a short healing period,Kaleb set his focus on finding a heavy-dutyprosthetic leg that could keep up with him onthe farm and help him get where he needed togo as a college student on campus.

Kaleb began his animal science major at Kirkwood Community College. While there, Kaleb was introduced to Iowa Vocational Rehab Services (IVRS), an organization whose aim was to make Kaleb’s education accessible. IVRS helped with parking issues, moving classes in case of snow or ice, and a variety of other needs for a shorter walking distance. IVRS saw Kaleb through two years at Kirkwood then through to graduation at Iowa State University.

Once Kaleb had graduated college and farming was once again his full-time focus, he got involved with Easterseals Disability Services, and they worked together to make farming easier. Walking on snow, ice, or mud caused many slips and falls, often leaving Kaleb injured and on the sidelines for a few days. Because of this, Kaleb, with the help of Easter Seals, began researching side-by-side ATVs and possible funding sources to help with the cost.

An ATV considered to be the best fit for Kaleb and his unique set of needs was purchased. He remembers getting the side-by-side home. It was a warm week and his new ride ran perfectly. But then the weather turned cold and immediately problems with the ATV began to appear. If the outdoor temperature was below

40 degrees, the side-by-side would struggle to start. If he was able to get it started, he couldn’t shut it down for long because then the machine would be reluctant to start again.

Twice the ATV was brought in. Both times Kaleb was left with an assistance machine that refused to function as it should have in the cold. Kaleb and his Easterseals representative came to find that this was a common problem with his model of ATV. Calls were made to the company explaining the situation and why it was imperative to solve, to no avail. The six-month warranty was useless because nothing had happened that qualified as a problem under the warranty.

While going around and around the company, a belt drive went out on the ATV. Then a u-joint broke and Kaleb gave up any attempt at using the machine in the winter months. The attorney general of Iowa even got involved, but that wasn’t enough to inspire the ATV company to find a solution.

AFTER AN INCREDIBLY FRUSTRATING PERIOD OF TIME where Kaleb was back to walking through dangerous conditions and falling regularly, he went back to IVRS for help and sought assistance from advocates at Disability Rights Iowa. As a result of these efforts, IVRS found Kaleb free of any fault and agreed to assist in the purchase of a second side-by-side.

They found a newer model from a different ATV manufacturer after copious amounts of research. This machine had a raised middle floor that offered a place for his leg to rest, and it had a three-year warranty. After the new ATV arrived on Kaleb’s farm, it performed its functions well and helped Kaleb maintain his 500-acre farm.

With the help of IVRS, Disability Rights Iowa, and Easter Seals, Kaleb got back to his passion of farming. When asked if he ever thought he would give up farming, Kaleb replied, “No, come hell or high water, I was farming. I appreciate the people who work in an office, but I just couldn’t handle it. I was going to get my butt in a tractor seat one way or another, so we figured out how to get it done.”

PAGE 12

10For many farm family members and rural residents with a disability, Easterseals Iowa Rural Solutions represents their only hope of returning to farming and their communities.

Rural Solutions offers agricultural work site and home modification consultations, peer support, services for the family, information and referrals, and medical equipment loan services. Team members are knowledgeable about resources throughout the state that can address the unique needs of rural family members with disabilities and actively pursue services that will enhance their lives.

Any farm family member with a disability or individual with a disability living in a town with a population less than 2,500 is eligible for services through the Rural Solutions program. Easterseals Iowa Rural Solutions services are provided free of charge to the individual and family receiving the services.

EASTERSEALS IOWA RURAL SOLUTIONS

After a snowmobile accident, Adam knew he wanted to continue farming and says he wouldn’t be able to live the life he has now without the support of Easterseals Iowa.

Easterseals Iowa gave me all the independence back that I could get, so I can do the things that I love to do. I didn’t have to give up. I could keep going and live life normally.

~Adam

The Easterseals Iowa Assistive Technology Program is made possible through funding from the Center for Disabilities and Development at University of Iowa Health Care supported by the State Assistive Technology Program grant from the U.S. Department of Health and Human Services Administration for Community Living.

The Easterseals Iowa Assistive Technology Program helps Iowans learn about and access the assistive technology they need as part of their daily lives to learn, work, play, and participate in community life safely and independently.

• Equipment Loan:

Easterseals Iowa loans durable medicalequipment: electric hospital beds, electric andmanual wheelchairs, and adaptive bathroomdevices. Visit www.easterseals.com/ia/at toobtain an application. Call 515-309-2395 oremail atinfo@eastersealsia.org to schedule anappointment to pick up or donate equipment.

• Demonstration Center:

The Demonstration Center is a valuable resourcethat showcases different types of assistivetechnologies to clients before it is brought totheir homes. By appointment only. Call toll free866-866-8782 or email atinfo@eastersealsia.org.

• Lending Library:

Equipment and resources are available forfamilies, individuals, counselors, and schools.The Lending Library is a great way to makesure a product works for you before making apurchase. It is free to all Iowans, and five itemsmay be checked out at a time for up to 30days. Visit www.eastersealsia.at4all.com to viewinventory. Questions? Call 866-866-8782 or sendan email to atinfo@eastersealsia.org.

• Iowa Assistive Technology Exchange:

This is a “classified ads” feature that connectspeople with available assistive technology. Visitwww.eastersealsia.at4all.com to see currentitems.

Besides helping with farm equipment modifications like hand controls, Easterseals also donates and loans items to individuals with disabilities. The equipment used includes, but is not limited to:

• A headlamp for working onvehicles or in darker spaces

• Adaptive or long-reachgardening tools

• Adaptive fishing equipment

• CCTV for help reading small print

• Adaptive hiking equipment

• Adaptive mobility equipment

• Adaptive exercise equipment

I love Easterseals Iowa. I didn’t know anything about a bike odometer when I first bought my bike. When I told the Assistive Technology staff that I wanted to track my distance and set goals, they helped me by loaning the odometer. They even trained me on how to set it up and use it.

At first I couldn’t ride very far, but now I can ride the entire 74-mile Raccoon River Valley Trail! I think it was a great help for my overall health and wellness. After my 30-day trial period Lending Library loan was successful, the staff helped direct me to a vendor where I could purchase one for myself. ~JasonCheck the Easterseals website for technology

availability or call the Assistive Technology Center at 866-866-8782.

PAGE 14

IOWA VOCATIONALREHABILITATION SERVICESApproaching employment opportunities as a person with a disability can be a challenging prospect. Some individuals are attempting to adapt to a new disability while continuing a beloved job. Others are embarking on a new employment opportunity for the first time. Many resources exist to help people with disabilities who are looking to farm or expand their farm to enable financial independence.

The most significant resources available to help people with disabilities meet these goals are the services provided by Iowa Vocational Rehabilitation Services (IVRS). IVRS is a federal program established to help people with disabilities find and maintain employment. While the services offered vary, everything is focused on helping people with disabilities achieve their work goal and secure financial independence.

HOW TO APPLY

Getting connected to IVRS is designed to be an easy process, and IVRS should move quickly to establish your eligibility and connect you with a counselor eager to get you on the road towards work. It all begins with a meeting at your local IVRS office, where staff will begin to establish if your disabilities qualify you for services. If so, they will determine what category of eligibility you are in and what services you are entitled to receive.

DETERMINING ELIGIBILITY

IVRS has 60 days from the time you apply to determine if you are eligible. Typically, individuals in the category “most significantly disabled” receive services first, with individuals in the category “significantly disabled” often placed on a waiting list and served as capacity allows.

MOST SIGNIFICANTLY DISABLED (MSD): The IVRS counselor has determined that you have a significant disability and are seriously limited in three or more functional areas.

SIGNIFICANTLY DISABLED (SD): The IVRS counselor has determined that you are an individual with a physical or mental disability that seriously limits one or two major life areas.

Areas include:

• Mobility

• Communication

• Self-care

• Self-direction

• Interpersonal skills

• Work tolerance

• Work skills

STARTING YOUR WORK WITH IVRS

Once your eligibility is established, IVRS will want to meet with you to discuss the process you are about to begin and what you can expect as a client. This is an important step because it equips you with the knowledge necessary to fully make use of their services and begin to plan a path towards your employment goal. As you begin the process, remember you have many rights as a consumer and as a person with a disability.

LIST OF RIGHTS

• You have the right to confidentiality

• You have the right to be treated withdignity and respect

• You have the right to direct services asyou move towards your employment goal

• You have the right to customized,substantive services, which, asappropriate, use the full array of servicesunder IVRS

LIST OF RESPONSIBILITIES

• For your work with IVRS, it is importantthat you engage fully in the process andwork to make it a success

• It is your responsibility to know as bestas you can what is reasonable to requestand what falls outside of IVRS services

DEVELOPING YOUR INDIVIDUAL PLAN FOR EMPLOYMENT

IVRS does not provide cookie-cutter services. Every individual should receive services that are customized to their needs. IVRS’ way of ensuring their services meet your needs is by drafting an Individualized Plan for Employment following your direction. Each plan for employment is unique and can require unique services and tools. The plan for employment is written by the individual receiving services with guidance from their IVRS counselor and desired circle of support. The plan is intended to be a road map to follow as they move towards their job goal. Anyone an individual chooses can assist them in writing a plan, but the plan and the job goal must be approved by IVRS. As you move towards your goal, you will have a variety of services to consider with your counselor.

COMMON IVRS SUPPORTS

• Vocational school assisted technologyevaluation, equipment, and training

• Disability resources information

• Supported employment

• Self-employment assistance

• Personal assistance services whilereceiving IVRS services

• Transportation in connection with IVRSservices

• Transition from school to work for youthwith disabilities

PAGE 16

SELF EMPLOYMENT

The Iowa Self-Employment Program from IVRS is extensive, but can be essential in the development of a feasible business plan and in securing funding for farm supports that fall outside of the scope of assistive technology. By using the Iowa Self-Employment Program, farmers can access funding to expand their farm or increase productivity, leading them closer to self-sufficiency provided their plan is approved. The IVRS program has many stages, each designed to assess and refine your needs and ensure you have a feasible business plan in place.

STAGES OF THE IOWA SELF-EMPLOYMENT PROGRAM

PLANNING: At this stage, you will explore whether or not self-employment is right for you and if you meet the prerequisite conditions for self-employment. This will include introductory conversations with your counselor, brainstorming about your eventual job goal, and if this track is right for you. Then you will fill out a variety of forms designed to see if self-employment will work with your particular situation.

APPLICATION: At this stage, you will complete the extensive Self-Employment Application. With the guidance of a self-employment counselor, you will also complete a business plan to attach to your application should you be seeking financial assistance from IVRS. At this point, you will also establish a match should you seek financial assistance. This match requires that for every dollar given by IVRS, you contribute a dollar to the business as well. This contribution can come in the form of a financial investment, equipment, or a Plan to Achieve Self-Support (PASS) written in conjunction with a benefits planner. You can contact Disability Rights Iowa for social security benefits planning services at no charge to you. Once established, this match can secure up to $10,000 in IVRS support provided that the business is found to be feasible and the needs merit the full amount.

BUSINESS PLAN FEASIBILITY STUDY: Per the IVRS Self-Employment Manual, “The purpose of a Business Plan Feasibility Study is to determine the likelihood of business success (feasibility) and develop a written guide that details the goals, business strategy, and operations (business plan). The Business Plan Feasibility Study will require an applicant to identify specific steps in the Business Planning Process as well as who will be involved in each step of the process, address budgetary guidelines, and provide a timeline.” In order to proceed, your plan will need to meet a certain viability score. If your plan fails to meet the needed score, you will have an opportunity for revision and continued work with the business specialist.

Important note for those on SSI: While in some cases forming a limited liability company as a farmer might be appealing, doing so would make you immediately ineligible for SSI. Before taking such a step, strategize with benefits planners at Disability Rights Iowa, at no cost to you.

Business Plan Implementation/Follow-up: Once approved, you will need to maintain a working relationship with your business specialist to see the business plan implemented, taking care to keep IVRS up-to-date on business progress and whether additional support is needed.

The Iowa Self-Employment Program can often be used in conjunction with other IVRS services such as assistive technology support, which does not have the same cap as self-employment. Talk with your IVRS counselor to find out which services are right for your needs.

ASSISTIVE TECHNOLOGY

Once approved for services, you and your IVRS counselor may determine that your disability will require assistive technology for you to be successful in a farming environment.

An assistive technology device is defined as any item, product system, or piece of equipment that is used to increase, maintain, or improve the functionalities of a person with a disability. Assistive technology can help someone perform a daily task or complete tasks in a work setting.

Don’t worry if you are lost as to what your assistive technology needs might be or if your barriers appear significant. IVRS has experts on staff available to help you identify your unique needs and the ways that assistive technology can help you perform to the best of your ability. Assistive technology can take many forms and is as varied as disability itself. Clients’ needs will range from logistical challenges of mobility to ways technology can help with planning for safety and everything in between.

Remember, it is IVRS’ responsibility to assess your assistive technology needs and what they can and cannot fund. Just because you might want a particular piece of equipment or accommodation does not mean the facts of your situation support it. Just like all IVRS services, everything is needs based and centered on the specifics of each client’s situation. Luckily, if you find yourself disagreeing with a decision, you have several remedies at your disposal.

ADDRESSING PROBLEMS WITHIN YOUR IVRS EXPERIENCE

IVRS is staffed by dedicated professionals eager to work with you in pursuit of your employment goals. However, as with any large government program, sometimes mistakes will be made or disagreements will arise. As a consumer of services, you have several administrative rights at your disposal to address concerns to get the supports to which you are entitled under the law. You have two resolution options at your disposal.

1INFORMAL RESOLUTIONS: Any decision reached by your counselor can be brought to the counselor’s supervisor, who can determine if the decision was appropriate and in line with IVRS policy. Also, you can at any time request an administrative review of the issue to see if an informal resolution can be reached. These steps are not required prior to requesting the formal resolutions listed below.

2 FORMAL RESOLUTIONS: At any time, you may request a mediation or fair hearing to challenge issues surrounding your application or a decision made by IVRS. IVRS may accept or reject your request for information; however, a fair hearing must be held should you request one. You can request a fair hearing within 90 days of the decision in question, at which point IVRS has 60 days to schedule a fair hearing. A fair hearing is presided over by a neutral hearing officer, and IVRS must abide by their decision.

PAGE 18

ADVOCATES HELP YOU GET THE SERVICES YOU NEED

Several advocacy organizations operate as a resource to IVRS consumers who do not believe they are receiving sufficient or appropriate services.

One option is the Client Assistance Program through the Department of Human Rights, Office of Persons with Disabilities. The Client Assistance Program can act as an intermediary between you and IVRS, working to find informal solutions to your IVRS issues and ensuring the staff are following correct procedure in a timely manner. The Iowa Client Assistance Program can be reached at 800-652-4298.

Disability Rights Iowa can also try to find a solution on your behalf by negotiating with IVRS. Disability Rights Iowa has the additional authority under federal law to pursue administrative, legal, and other relief on your behalf. If you want to request assistance from Disability Rights Iowa, please call their intake specialist at 515-278-2502, ext.12 so she can get basic information about you on your concerns. Disability Rights Iowa will then assess your case to determine if they have the resources to assist you.

Important Reminder: You should never be expected to negotiate away any of your rights as an IVRS client, nor do you need to compromise your work goals. If you are unsure if IVRS is correctly following policy, check with one of the advocacy resources listed in this guide.

Renae’s Story

RENAE BEEBOUT LIVES IN WESTERN IOWA and comes from a long line of farmers. Like the family before her, she wanted to farm and knew she and her husband would make a great team. Because Renae was born with cerebral palsy, she had many unique challenges she would have to address in order to pursue farming full time. Luckily, with the help of Easterseals and advocacy provided by Disability Rights Iowa, she reached out to IVRS to begin to identify what supports she would need to achieve her work goal.

After discussions with her counselor, Renae decided IVRS’ Iowa Self-Employment Program was the best fit for her needs. She, along with her IVRS counselor and IVRS business specialist, established a viable business plan. Renae then received a technology assessment to determine what technology might help her farm. Through technology and IVRS’ Iowa Self-Employment Program, Renae was able to get assistance purchasing a mobility vehicle specialized to her disability, accessible gates on her farm, an outdoor shed to preserve her equipment, and more.

Thanks to IVRS, Disability Rights Iowa, and Easter Seals, Renae has the tools she needs to grow her farm and eliminate any barriers her disability may have posed to achieving her goal.

To learn more about Renae’s family farm, visit www.triplearrowfarm.com/.

PAGE 20

WORKING WITH AGRABILITYThe vision of AgrAbility3 is to enhance quality of life for farmers, ranchers, and other agricultural workers with disabilities, so that they, their families, and their communities continue to succeed in rural America. For this target audience, “success” may be defined by many parameters, including: gainful employment in production agriculture or a related occupation; access to appropriate assistive technology needed for work and daily living activities; evidence-based information related to the treatment and rehabilitation of disabling conditions; and targeted support for family caregivers of AgrAbility customers. In the past, Iowa had a USDA-funded Agrability Project. Although Iowa no longer has this project, the Agrability website at http://www.agrability.org/ contains useful information for all farmers.

AGRABILITY ADDRESSES A WIDE VARIETY OF DISABLING CONDITIONS IN AGRICULTURE, INCLUDING, BUT NOT LIMITED TO:

• Arthritis

• Spinal cord injuries/paralysis

• Back impairments

• Amputations

• Brain injury

• Visual impairments

• Hearing impairments

• Disabling diseases

• Cerebral palsy

• Respiratory impairments

• Head injury

3The National AgraAbility Project is funded through the United States Department of Agriculture (USDA) National Institute of Food and Agriculture. AgraAbility was established in the 1990 Farm Bill. NAP team members include Purdue University’s Breaking New Ground Resource Center, Goodwill of the Finger Lakes; Colorado State University; APRIL (Association of Programs for Rural Independent Living) and various Consultants.

ONE OF THE MOST USED RESOURCES on the National Agrability Project (NAP)website is The Toolbox: Agricultural Tools, Equipment, Machinery & Buildings for Farmers and Ranchers with Physical Disabilities (www.agrability.org/toolbox/). The Toolbox is a resource that contains assistive technology solutions for farmers, ranchers, and other agricultural workers with disabilities. A farmer can view by category or search the toolbox to find products, designs, ideas, techniques, or suggestions. In addition to the database, there are several technical reports, providing techniques and suggestions focused on a specific topic on farming/ranching with a disability.

Examples of assistive technology in the Toolbox include:

• Agriculture-related enterprises

• Crop and materials handling/storage

• Gardening

• Lawn care

• Livestock handling/housing

• Outdoor mobility

• Outdoor recreation

• Safety and health

• Shops and shop tools

• Skid-steer loaders and otherself-propelled equipment

• Tractors and combines

• Tree fruits and nurseries

• Trucks

• Utility vehicles, ATVs, andother off-road vehicles

• Vegetable, small fruit, andflower production

PAGE 22

MODIFYING YOUR HOME AND FARMThere are numerous farmers with disabilities who would benefit from having modifications to their homes. Most of the houses in rural areas are made up of older homes passed down from generation to generation. Some old houses are multi-story, have basements, narrow doorways and very small bathrooms.

Try to look at how the house is built, the layout, and objectively consider whether it is meeting your needs to stay at home, especially with respect to prevent you from falling.

Although the Americans with Disabilities Act and the Fair Housing Act do not apply to single-family homes, the most commonly needed modifications are ramps, bathroom grab bars, railings on both sides of a stairway, widening of door frames, repair and removal of inadequate or uneven flooring. Just as you many need to modify your home, you may also may have to modify certain aspects of your farm, barns and other buildings.

While you, family or a local contractor can make some of these home modifications at a relatively low cost, you may need to identify resources and financial assistance for other home modifications. See the resources page at the end of this guide.

The following goes in-depth for what you need to consider when making the decision about whether or not you can stay in your current home.

APPROACH

You might spot several potential hazards as you approach your house. The approach is usually the space between where you get out of your vehicle and the front door. Start with the surface that you have to walk or wheel on – is it sandy, muddy, graveled or paved? Is the surface even or full of potholes? Are sidewalks too narrow or too rough? Make sure to consider how the approach changes depending on weather. Next, move to the front door area of the house. Do you have stairs? Are there railings on each side of the stairs? If you have to wheel up to the home, then stairs and door thresholds are going to be issues that have to be dealt with. If you have to install a ramp, make sure that you use a rule of thumb that for every 12” step that you have 12’ of ramp. Also, replace your door threshold with a flat one.

HOME INTERIOR

Once inside your home, look at the floor surfaces. Are there clear pathways or other potential hazards? You may want to make the following changes; repair flooring, or replace carpeting for something easier to wheel on, remove clutter, clear pathways, increase lighting and install adapted knobs if switches are hard to turn.

INTERIOR STAIRS

Are there sturdy railings on either side of the stairs? Are the stairs too steep for climbing? If you cannot negotiate the stairs, will you have to put a stair lift in?

BATHROOM

There may be several potential hazards in this room that need to be changed. Swing away door hinges can enable precious width to a narrow door, just enough to allow room for a wheelchair or walker. If fatigue or balance is an issue, a proper bath chair or bench will allow sitting down while bathing. Many home improvement stores now carry a line of bathroom safety products that can be installed by a family member with common tools. Depending on the disability, bathrooms may be your most expensive alteration.

BEDROOMS

Survey your bedroom and make sure that any trip hazards created by rugs or cords are removed. Many individuals fall because they trip over bedding or extension cords. Think about reconfiguring your closets so that clothing and other items can be easily reached. Is it possible to move your bedroom to the main floor and stay away from 2nd or 3rd floors?

KITCHEN

Does the kitchen have enough space to turn around in? Can you get into the refrigerator and operate the stove or oven? Can you get into the cupboards and pantry? Many changes can be made in the kitchen to make life easier and safer for you. Some are relatively inexpensive, others can be quite costly.

PAGE 24

STRESS AND MENTAL HEALTH“It is normal to experience change in our lives. Even though we may expect normal change, it can still create stress. Sometimes our expectations about the results of change are unrealistic. Unexpected changes also impact families with tragic loss. Death or disabling injury or illness, divorce, and job loss can turn life upside down. Readjustment can be slow and painful. We need to be sure to care for ourselves and others during these stressful situations.”

Iowa Concern Hotline, Iowa State University, Extension and Outreach https://www.extension.iastate.edu/iowaconcern/caring.html

To assist, Iowa Concern has stress counselors that can talk with you over the phone (1-800-447-1985) or in a one-on-one live chat. You can also email an expert (caringexpert@iastate.edu) or review the frequently asked questions. Referrals for mental health counseling can also be accessed through Iowa Concern.

TIPS FOR CARING FOR YOUR MENTAL HEALTH (NAMI: Taking Care of Yourself)

1. Understand how stress affects you.Stress can affect your entire body.

Common signs include:

• Headaches

• Nausea

• Muscle tension

• Insomnia

2. Protect your physical health. Goodphysical health can improve mentalhealth as well.

Try to:

• Exercise and eat healthy

• Set a sleep schedule

• Avoid recreational drugs and alcohol

• Practice relaxing and existing in themoment

• Remember to take a break

3. If you’re constantly “on” it can be hardto recharge your batteries.

Try:

• Taking five minutes to do somethingyou enjoy

• Listening to your favorite music

• Taking a short nap to recharge

• Practice healthy mental habits

4. As cliché as it sounds, “staying positive”can do wonders for your mental health.

Try to:

• Avoid guilt

• Focus on nice things that happenedthroughout the day

• Glean strength and happiness fromyour support system

LIVING INDEPENDENTLY WITH A MENTAL HEALTH CONDITION

The Center for Independent Living in San Mateo, California, has this to say about remaining independent while dealing with a mental condition:

The best way to remain as independent as possible, as someone with a psychological condition is most likely to seek treatment. This can be difficult at first if you are finding it hard to accept your diagnosis, but if there is an underlying organic condition it is imperative to get help. Remember, mental illness is an organic disease of the brain, not a character flaw. There is nothing to be ashamed of or embarrassed about. You will have to create your own support system of people you trust, and have faith in their efforts to bring you back to wellness. Oftentimes, mental illnesses cause people to do or say things that put them and possibly others in vulnerable situations. These repeated behaviors can lead to diminished trust, whether it is from loved ones, or whether it leads to legal consequences. If you are in the latter group, it may take time to rebuild trust in your relationships or to get out of legal embroilments.

Thus, in order to maintain or regain your independence, it is important to have patience and perseverance. Have faith that you will recover from the illness, or at the very least you will learn to cope with the symptoms. Ultimately, your support system will be there to help lift you up when you are in crisis, but the biggest effort will come from you.

PAGE 26

MOVING FORWARD

Farmers and ranchers with disabilities usually reach a point during recovery when they want to return to their work. This often requires taking control of a new situation as well as learning about resources and support available for returning to agricultural production. It requires being able to make a plan, communicate the plan, set realistic goals, and create strategies to help you meet your goal.

Start the path back to work by taking stock. Next, build a strong support system of family members, friends, neighbors, other farmers, and community members. Then, together with your support circle, you can work on a plan.

TO CONSTRUCT A STRONG PLAN TO GET BACK TO WORK WITH A SOLID FOUNDATION, FOLLOW THESE 6 STEPS:

1. Analyze the situation. What are your starting conditions, and where do you want to end up?

2. Test your assumptions. Know the reality of your situation and capacity.

3. Evaluate your needs. What do you need to complete your goal?

4. Set realistic goals. Don’t push yourself too far, but also don’t set the bar too low.

5. Plan activities to meet your goal. Have smaller goals as markers along the way for progress.

6. Evaluate your progress. Are you moving ahead at a good pace? If not, what can you change?

THINGS TO KEEP IN MIND AS YOU PROGRESS: Getting back to work could be a long process. There are three things that you need to keep in mind as you progress to your goal: self-management, evolving expectations, and quality of life. Self-management helps you re-establish agency in your life. Knowing about change ahead of time helps you prepare for it. Monitoring the quality of life for yourself and those around you will lead to a happier journey to meet your goals. All three are explained in more detail below.

TIP: All of the chores and tasks you did prior to your disability can still be done, but you might have to learn a new way to do them. Allow for extra time in your first year to find your new rhythm.

CHANGING ROLES AND EXPECTATIONS

A recently acquired disability can add to the stress an individual and loved ones experience. Disabilities may elicit negative feelings because the disability brings a great deal of change to an individual’s life and to all those surrounding them.

A disability often brings changes in roles for the individual experiencing the disability as well as the family members. A farmer or rancher may have to renegotiate a role in the business that can accommodate their disability rather than being pushed out of the operation. In addition, a husband, wife, or child may unexpectedly have to take on a caregiver role because of a family member’s disability. It is important to consider all avenues of care at home.

See the references at the end of this guide if you are curious about at-home care options like Medicaid-Home or Community Based Waiver.

QUALITY OF LIFE

Quality of life comes from the enjoyment of being with those we love. Family celebrations and routines are important for maintaining family communication and satisfaction. Spending time with family can be a means for expressing appreciation and strengthening relationships as well as providing comfort, support, and security. After a serious illness, injury, or disabling event, the usual pattern of family life can be disrupted. Members may be unsure of when or how to get back to the usual routines or how to adapt and create new routines. There is no “right” way to return to a sense of routine; each family must find their own way to stability.

Children will need extra reassurance after a traumatic event. Allow them to ask questions and encourage them to talk. Validate their concerns, even if they don’t seem relevant to you. Remember that children often personalize what has occurred and may worry about their own safety and that of the family. It is especially important to help them regain hope for the future by including them in the process.

SELF-MANAGEMENT TIPS TO GET BACK TO WORK

In order to get back to work in an effective manner, you need to know how to self-manage many of the challenges that come with your disability. Answer the following question: How confident are you that you can self-manage your health conditions?

It is a good idea to know the names, dosages, and conditions that your medications cover. Most of us know enough about our health that we know about our conditions, medications, and doctor recommendations. However, we often don’t know the finer details of everything about our health and wellness. In order to take an active role in your health, consider asking your doctor any questions you have. Informing your close support network of anything you might need help with.

Your healthcare team is made up of doctors, nurses, social workers, psychologists, pharmacists, and any other medical professionals who care for your physical and mental health. Each member of your team is specially trained to treat certain aspects of your chronic illness or disability. Make sure to communicate openly and honestly with your healthcare team. If one member of your team cannot answer a question, other members of your team should be able to help. If you continue to have problems, it is okay to change healthcare professionals. If you can’t find any other doctors or specialists near you, look into talking to a specialist over the phone or using Teladoc services.

PAGE 28

RESOURCES RECAPThe prior pages look at how you can reduce risks to your health and safety and plan to move forward in your life with a disability.

FEATURED RESOURCES

Easterseals Rural Solutions Program offers agriculture work site and home modifications consultants along with assistive technology equipment. www.eastersealsia.org 515-309-1300

I-CASH provides assistance and programsto make Iowa’s farmers safer.www.public-health.uiowa.edu/icash 319-335-4190

IABLE allows you to save for qualified disability expenses without losing your eligibility for certain assistance programs, like SSI and Medicaid.www.iable.gov 888-609-8910

Iowa ABLE Foundation Loan Program is a statewide non-profit helping Iowans with disabilities and the aging achieve and maintain independence through microlending programs and financial coaching. www.iowaable.org 888-222-8943

Iowa Compass connects people with disabilities and complex health-related needs to services and supports in their communities throughout Iowa. Services are free of charge. www.iowacompass.org 800-779-2001

Iowa Medicaid may provide assistance for home modifications. www.medicaidwaiver.org 877-347-5678

Iowa Vocational Rehabilitation Services offers self-employment and voc rehab help. www.ivrs.iowa.gov 800-532-1486

Lifelong Links - Iowa’s Aging and Disability Resource Center helps Iowans achieve their personal goals for independence and full participation in their community. LifeLong Links provides information to older adults, people with disabilities, veterans and caregivers as they begin to think about and plan for long-term independent living. LifeLong Links is modeled on the “no wrong door” approach, meaning it is available to any Iowan in need of home-based and community services and is accessible through physical locations across Iowa.

www.lifelonglinks.org 866-468-7887

NAMI serves as a catalyst around advocacy, education, support, and public awareness so that all Iowans affected by mental illness can lead better lives. www.nami.org 800-950-6264

ACKNOWLEDGEMENTS

ACKNOWLEDGEMENTS

Disability Rights Iowa would like to thank the following individuals and organizations for their help in the development of this guide:

Oklahoma Partners

Oklahoma State University Extension

Oklahoma ABLE Tech at Oklahoma State University (ABLE TECH)

Oklahoma Assistive Technology Foundation (OK AT)

Ag4Life (an affiliate of the National AgrAbility Project)

Linda Jaco, director, Oklahoma ABLE Tech

Carla Wilhite, assistant professor, New Mexico State University (School of Medicine)

Iowa Partners

Easterseals Rural Solutions Program

Iowa Vocational Rehabilitation Services

Iowa Center for Agricultural Safety and Health

PAGE 30

Disability Rights Iowa (DRI) aims to defend and promote the human and legal rightsof Iowans who have disabilities and mental illnesses. You can contact DRI if you

have issues with anything addressed in this booklet.

400 East Court Ave., Ste. 300Des Moines, Iowa 50309

515-278-2502 or 1-800-779-2502www.driowa.org